14 (0.9%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza. All four subtyped influenza A viruses were 2009 influenza A (H1N1). The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold. No influenza-associated pediatric deaths were reported. The proportion of outpatient visits for influenza-like illness (ILI) was 0.8%, which is below the national baseline of 2.3%. All 10 regions reported ILI below region-specific baseline levels. No states reported widespread or regional influenza activity. One state reported local influenza activity. Puerto Rico and 19 states reported sporadic influenza activity. The District of Columbia, Guam, and 30 states reported no influenza activity, and the U.S. Virgin Islands did not report.

18 June 2010 -- As of 13 June, worldwide more than 214 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 18172 deaths.

WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and Member States and through monitoring of multiple sources of information.

Situation update: The situation remains largely unchanged since the last update. Overall pandemic influenza activity remains low worldwide with geographically limited circulation of pandemic influenza virus in parts of the tropics, particularly in parts of Central America and the Caribbean and in parts of South and Southeast Asia. Seasonal influenza type B viruses continue to circulate at low levels across Asia and to a lesser extent across parts of Africa and South America. Recently re-emerged seasonal influenza H3N2 viruses continue to circulate in East Africa. As countries of the temperate southern hemisphere enter winter, overall only sporadic influenza activity has been detected so far.

Large article with links to other information is continued at link below.....

FDA Warns About Fraudulent TamifluFraudulent product is dangerous to patients allergic to penicillin

The U.S. Food and Drug Administration today warned consumers about a potentially harmful product represented as “Generic Tamiflu” sold over the Internet. FDA tests revealed that the fraudulent product does not contain Tamiflu’s active ingredient, oseltamivir, but cloxacillin, an ingredient in the same class of antibiotics as penicillin.

The agency reminds patients who are allergic to or may have experienced adverse reactions from penicillin products that they are at risk of experiencing similar reactions from cloxacillin. This includes a sudden, potentially life-threatening reaction called anaphylaxis, with symptoms that include difficulty breathing, chest tightness, swelling of the throat or tongue, hives, dizziness, loss of consciousness, or a rapid or weak pulse. To date, the FDA is not aware of any reports of adverse reactions.There is no FDA-approved generic drug for the prescription product Tamiflu.

The FDA bought the fraudulent “Generic Tamiflu” without a prescription from a website claiming to be an online drugstore that is no longer operational. The fraudulent version is likely to be found for sale on other websites, however.

A universal influenza vaccine — so-called because it could potentially provide protection from all flu strains for decades — may become a reality because of research led by scientists from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

In experiments with mice, ferrets and monkeys, the investigators used a two-step immunization approach to elicit infection-fighting antibodies that attacked a diverse array of influenza virus strains. Current flu vaccines do not generate such broadly neutralizing antibodies, so they must be re-formulated annually to match the predominant virus strains circulating each year.

"Generating broadly neutralizing antibodies to multiple strains of influenza in animals through vaccination is an important milestone in the quest for a universal influenza vaccine," says NIAID Director Anthony S. Fauci, M.D. "This significant advance lays the groundwork for the development of a vaccine to provide long-lasting protection against any strain of influenza. A durable and effective universal influenza vaccine would have enormous ramifications for the control of influenza, a disease that claims an estimated 250,000 to 500,000 lives annually, including an average of 36,000 in the United States."

In parallel experiments with mice, ferrets and monkeys, Dr. Nabel and his colleagues first primed the animals’ immune systems with a vaccine made from DNA encoding the influenza virus hemagglutinin (HA) surface protein. After being primed with DNA vaccine, the mice and ferrets received a booster dose of the 2006-2007 seasonal influenza vaccine or a vaccine made from a weakened cold virus (an adenovirus) containing HA flu protein. Monkeys were boosted with the seasonal flu vaccine only.

This prime-boost vaccine stimulated an immune response to the stem of the lollipop-shaped hemagglutinin of influenza virus. Unlike HA’s head—which mutates readily, allowing the virus to become unrecognizable to antibodies—the stem varies relatively little from strain to strain. In principle, Dr. Nabel explains, antibodies generated against the stem of HA should be able to recognize and neutralize multiple flu strains.

Although the DNA in the priming vaccine was derived from a 1999 circulating flu virus, all the animals made antibodies capable of neutralizing virus strains from several other years. Mice and ferrets produced antibodies not only against virus strains dating from before 1999, including a strain that emerged in 1934, but also against strains that emerged in 2006 and 2007.

Moreover, although the prime-boost vaccines were both made from H1 subtypes of influenza A virus, the antibodies they generated neutralized other influenza subtypes, including H5N1 (avian influenza) virus. This indicates that a prime-boost strategy potentially could confer immunity to many or all subtypes of influenza A, says Dr. Nabel.

In another set of experiments, the scientists measured how well the prime-boost vaccine protected mice and ferrets from infection with deadly levels of flu virus. Three weeks after receiving the boost, 20 mice were exposed to high levels of 1934 flu virus, and 80 percent survived. Mice receiving DNA only, seasonal flu vaccine only or a sham prime-boost vaccine all died.

The researchers saw similar results when they tested several prime-boost combinations in ferrets, which are considered a good animal model for predicting flu vaccine efficacy in humans. All four ferrets that received a DNA prime-seasonal boost were protected from infection with a 2007 virus strain, while all six ferrets that received the DNA prime-cold virus boost combination were protected from the 1934 influenza virus.

Collaborators on these studies included Terrence Tumpey, Ph.D., of the Centers for Disease Control and Prevention.

“We are excited by these results,” says Dr. Nabel. “The prime-boost approach opens a new door to vaccinations for influenza that would be similar to vaccination against such diseases as hepatitis, where we vaccinate early in life and then boost immunity through occasional, additional inoculations in adulthood.”

Trials of prime-boost influenza vaccines assessing safety and ability of the vaccine to generate immune responses are already under way in humans, Dr. Nabel adds. The information from the new research will be valuable in selecting candidates to move forward into large-scale trials, he says. “We may be able to begin efficacy trials of a broadly protective flu vaccine in three to five years.”

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

The U.S. Food and Drug Administration announced today that it has approved vaccines for the 2010-2011 influenza season in the United States.

Seasonal influenza vaccine protects against three strains of influenza, including the 2009 H1N1 influenza virus, which caused the 2009 pandemic. Last year because the 2009 H1N1 virus emerged after production began on the seasonal vaccine, two separate vaccines were needed to protect against seasonal flu and the 2009 H1N1 pandemic flu virus, but this year, only one vaccine is necessary.

According to the Centers for Disease Control and Prevention (CDC), between 5 percent and 20 percent of the U.S. population develops influenza each year, leading to more than 200,000 hospitalizations from related complications and about 36,000 deaths.

“The best way to protect yourself and your family against influenza is to get vaccinated every year,” said Karen Midthun, M.D., acting director of FDA’s Center for Biologics Evaluation and Research. “The availability of a new seasonal influenza vaccine each year is an important tool in the prevention of influenza related illnesses and death.”

In addition to the important role that health care providers play in recommending influenza vaccination for their patients, influenza vaccination of health care personnel is important to protect themselves, their patients, their family, and the community from influenza. FDA urges health care organizations to encourage their members to get vaccinated.

Each year, experts from FDA, World Health Organization, CDC, and other institutions study virus samples and patterns collected worldwide to identify strains likely to cause the most illness during the upcoming season.

Based on that information and the recommendations of FDA’s Vaccines and Related Biological Products Advisory Committee, manufacturers included the respective three strains in the 2010-2011 vaccines. The closer the match between the circulating strains and the strains in the vaccine, the better the protection against influenza disease.

Vaccines for the 2010-2011 seasonal influenza contain the following strains:

There is always a possibility of a less than optimal match between the virus strains predicted to circulate and the virus strains that end up causing the most illness. However, even if the vaccine and the circulating strains are not an exact match, the vaccine may reduce the severity of the illness or may help prevent influenza-related complications.

Seasonal influenza vaccines have a long and successful track record of safety and effectiveness in the United States.

The labeling for one vaccine, CSL Limited’s Afluria, has undergone changes this season to inform health care providers about an increased incidence of fever and febrile seizure, which was seen in young children, mainly those younger than 5 years, following administration of the 2010 Southern Hemisphere formulation of CSL’s influenza vaccine. The Southern Hemisphere influenza season occurs prior to that of the Northern Hemisphere. CSL Limited will not be supplying the United States with the 0.25 milliliter single-dose, prefilled syringes, which are used in very young children. The 0.5 milliliter single-dose, prefilled syringes and 5 milliliter multi-dose vials will be distributed.

FDA is requiring CSL Limited to conduct a study of Afluria in children to obtain additional information regarding the febrile events that were seen in the Southern Hemisphere.

CDC has published recommendations for annual influenza vaccination to include all people aged 6 months and older. The expanded recommendation is to take effect in the 2010-2011 influenza season. The Advisory Committee on Immunization Practices (ACIP), which advises the CDC on vaccine issues, voted on the new recommendation during its February 24, 2010 meeting in Atlanta.

Prior recommendations for seasonal influenza vaccination focused on vaccination of persons at increased risk for complications from influenza including people with underlying health conditions, children 6 months through 18 years of age, and close contacts of high risk persons among others.

SummaryThis report updates the 2009 recommendations by CDC's Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccine for the prevention and control of influenza (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2009;58[No. RR-8] and CDC. Use of influenza A (H1N1) 2009 monovalent vaccine---recommendations of the Advisory Committee on Immunization Practices [ACIP], 2009. MMWR 2009;58:[No. RR-10]). The 2010 influenza recommendations include new and updated information. Highlights of the 2010 recommendations include 1) a recommendation that annual vaccination be administered to all persons aged ≥6 months for the 2010--11 influenza season; 2) a recommendation that children aged 6 months--8 years whose vaccination status is unknown or who have never received seasonal influenza vaccine before (or who received seasonal vaccine for the first time in 2009--10 but received only 1 dose in their first year of vaccination) as well as children who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine regardless of previous influenza vaccine history should receive 2 doses of a 2010--11 seasonal influenza vaccine (minimum interval: 4 weeks) during the 2010--11 season; 3) a recommendation that vaccines containing the 2010--11 trivalent vaccine virus strains A/California/7/2009 (H1N1)-like (the same strain as was used for 2009 H1N1 monovalent vaccines), A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens be used; 4) information about Fluzone High-Dose, a newly approved vaccine for persons aged ≥65 years; and 5) information about other standard-dose newly approved influenza vaccines and previously approved vaccines with expanded age indications. Vaccination efforts should begin as soon as the 2010--11 seasonal influenza vaccine is available and continue through the influenza season. These recommendations also include a summary of safety data for U.S.-licensed influenza vaccines. These recommendations and other information are available at CDC's influenza website (http://www.cdc.gov/flu); any updates or supplements that might be required during the 2010--11 influenza season also will be available at this website. Recommendations for influenza diagnosis and antiviral use will be published before the start of the 2010--11 influenza season. Vaccination and health-care providers should be alert to announcements of recommendation updates and should check the CDC influenza website periodically for additional information.

You’ve probably heard of patches for delivering nicotine-replacement therapy or hormones for birth control. But what about other uses, such as vaccination? For many years, researchers have been working to find a way to deliver flu vaccine – whose components are much larger than those of nicotine and hormones – using a transdermal (across the skin) patch. One method, developed by scientists at the Georgia Institute of Technology and Emory University, uses a new type of patch made of dissolving microneedles, which are tiny, painless needles that allow flu vaccine to pass through the skin.

A new study led by Mark Prausnitz, Ph.D., and Sean Sullivan, Ph.D., of Georgia Tech, and Dimitrios Koutsonanos, Ph.D., Ioanna Skountzou, Ph.D., and Richard Compans, Ph.D., of Emory University, compared microneedle patches to traditional hypodermic needles to vaccinate mice against the flu. The microneedles in this study were made of the polymer polyvinylpyrrolidone, a compound that has been previously tested and found to be nontoxic. The investigators found microneedles to be at least as effective as hypodermic needles, and by some measures, more so. The research was supported by NIAID and the National Institute of Biomedical Imaging and Bioengineering (NIBIB).

Microneedle Patches: A Melding of Engineering and BiologyDr. Prausnitz’s lab has spent several years studying vaccine delivery. “Our goal is to use engineering technology to solve drug delivery problems,” he explains. “We want to administer vaccines in a way that would be easy for patients.”

The investigators used an innovative method to create the microneedle patches. In a process known as in situ polymerization, they mixed liquid vinylpyrrolidone with the vaccine, poured the mixture into a microneedle mold, and exposed it to ultraviolet light. This induced polymerization, creating much larger molecules.

Once placed on the skin, the microneedles pass through the surface skin layers, moisten, and dissolve, delivering flu vaccine to antigen-presenting cells in the skin. These cells then break down antigens and display them to other immune cells. The body mounts an immune response to those antigens, and is thereby prepared to fight off the virus in the future. When the microneedles fully dissolve – within a few minutes – the patch can be removed and disposed.

Testing Immunity from Microneedle-Delivered VaccineAfter vaccination, the researchers measured flu antibody levels in the blood and found no difference between mice who received the microneedle vaccine and those who received a hypodermic injection. In fact, when vaccinated mice were exposed to flu virus, those that received the microneedle vaccine were significantly better protected than those that received a hypodermic injection. Four days after being exposed, mice in the microneedle group were able to clear the virus out of their lungs 1000 times more efficiently than mice in the hypodermic group.

“Viral load is an important measure because it addresses the source of the problem: virus in the lungs. Microneedle vaccination brought the viral load in the lungs almost to zero,” says Dr. Prausnitz. A reduced viral load may also have implications for the infectivity of flu; if a person expels less virus with a cough or sneeze, transmission may be reduced.

Microneedle patches also have practical advantages over traditional hypodermic injections: they take up less space in clinics, do not require special disposal (as hypodermics do), are inexpensive to make, and may be simple enough for patients to self-administer at home. Because of these advantages, they could have important benefits for public health. If these results can be replicated in humans, not only would people who receive the vaccine be better protected from the flu, but it may be easier for more people to get vaccinated. If more people are vaccinated, fewer people are likely to get sick and be able to pass the virus on to others, lowering everyone’s chances of being exposed.

Looking to the FutureThe researchers are currently exploring the reasons why microneedle delivery resulted in reduced viral load in mice. Microneedle skin patches target a different set of immune cells than conventional intramuscular injection, notes Dr. Prausnitz. “I don’t think the improvement in immunogenicity is something unique to microneedles, but rather is unique to delivery through the skin. Microneedles enable that to take place,” he says. In answering this question, they are studying the immunologic pathways triggered by delivery to the skin, and hoping to harness these pathways to improve immunogenicity.

They are also reaching out to experts in other infectious diseases, to test this delivery approach with different vaccines. Dr. Prausnitz cites the growing importance of collaboration in this research. “This study is one of more and more examples where the tools of engineering can be combined with the expertise of bioscientists, to obtain results that would have been hard to get without collaboration.”

6 August 2010 -- As of 1 August 2010, worldwide more than 214 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 18449 deaths.

WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of information.

ORANGE CITY - Due to an outbreak of swine flu in Venezuela and Mexico Health Department here is an urgent call to take precautions. Presumably this is a person infected with the disease.Maribel Tromp Department of Health says that the flu primarily affects the respiratory tract. "Those who have respiratory problems, will be extra may experience the flu, even fatal consequences." Risk groups (children aged between zero and four years, pregnant women, people with a chronic illness and 60-plus) will therefore strongly advised to guard against flu, also known as influenza A (H1N1) to be vaccinated. "They can seek further guidance contact their doctor," said Tromp. ::snipping2::

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I stand with the girl, Natalee Holloway.

"We won't give up on you, Natalee. You didn't give up on us, and we will continue with the investigation until we have all of the answers to your disappearance. God be with you my Natalee!" Dave Holloway ARUBA